Perioperative Care Coordination Team at Children's Mercy Kansas City

Perioperative Care Coordination Team

Perioperative Care Coordination Team at Children's Mercy Kansas City

Perioperative Care
Children's Mercy Kansas City
Kansas City, Missouri
United States
Stephanie Meyer, MSN, FNP, RN, NEA-BC; Stacey Wood, MSN, RN, CPN; Gentry Ehlert, MSN, RN, CNOR; Paresa Tafreshi, MSN, RN, CPN; David Seefeldt, BSN, RN; Daniel Agne, DO; Damon Matlock, RRT-NPS

Earlier this month a patient's surgery (port placement) was canceled because the PICU beds were full, and the patient would need to be admitted to the PICU postoperatively. The patient is terminally ill and needed a port placed so he could go home for hospice to take over his care. The patient is vent dependent (home vent). His surgery was rescheduled for the following week, and as the surgery date approached, the PICU census remained at an all-time high. The patient was going to be canceled a second time, and the mom stated "if it's canceled again we will have to seek care at another hospital because he can't wait any longer." Knowing this patient has a complex history and has been followed here his entire life, the surgery team did not want to cancel. The OR leadership worked with PICU leadership and SDS/PACU leadership to facilitate a plan. We decided to go ahead with the surgery after asking anesthesia if they were comfortable with the patient recovering in the PACU and being discharged home from there. The surgical services team (Pre-op, OR, PACU) all agreed to move forward with the surgery. The morning of surgery, anesthesia questioned the plan and considered canceling, but the SDS Charge RN (Dave Seefeldt) stepped in to prevent this from happening. He explained the situation and the pre-work that had been done to coordinate this patient, and anesthesia then went ahead with the surgery. The PACU RN recovered this patient for almost four hours (most stays average 50 minutes) because she felt it necessary to get this patient's pain controlled to the best of her ability. Respiratory also stayed one on one with the patient during the entire recovery to manage the home vent (preventing transfer to the PICU). It truly took a team effort, but this patient successfully underwent a port placement and was discharged home the same day. The team did what was right to get the patient what he needed during a difficult time.